Provider Demographics
NPI:1194820654
Name:SCHAFERS, TARA E (RPH)
Entity Type:Individual
Prefix:
First Name:TARA
Middle Name:E
Last Name:SCHAFERS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:512 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:TRIPP
Mailing Address - State:SD
Mailing Address - Zip Code:57376-2107
Mailing Address - Country:US
Mailing Address - Phone:605-935-6255
Mailing Address - Fax:
Practice Address - Street 1:512 S MAIN ST
Practice Address - Street 2:
Practice Address - City:TRIPP
Practice Address - State:SD
Practice Address - Zip Code:57376-2107
Practice Address - Country:US
Practice Address - Phone:605-589-4418
Practice Address - Fax:605-589-4428
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD4939183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist